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What are the risk factors for aggravation of esophageal varices in patients with hepatocellular carcinoma?
J Gastroenterol Hepatol. 2007 Feb; 22(2):240-6.JG

Abstract

BACKGROUND AND AIM

The risk factors for aggravation of esophageal varices (EV) in patients with hepatocellular carcinoma (HCC) are poorly understood. The aim of this study was to evaluate the effects of HCC on the appearance of the red color (RC) sign on EV and also investigate whether risk factors for the appearance of the RC sign differed between patients with and without HCC.

METHODS

A total of 243 patients with cirrhosis (127 with HCC, 116 without HCC) without the RC sign, with no previous variceal hemorrhage, and not on prophylactic treatment for EV were enrolled. The endpoint was defined as being either when the RC sign was first noted, or when variceal bleeding occurred. In patients without HCC, follow-up was discontinued if HCC was discovered. The risk factors were analyzed by Cox proportional hazards regression.

RESULTS

In patients with HCC, portal vein tumor thrombus was a statistically independent risk factor (risk ratio [RR] 4.58, 95% confidence interval [CI] 1.32-15.86), although the presence of HCC was not. A large HCC (> or =50 mm) tended to be a risk factor, but this was not statistically significant (RR 2.50, 95%CI 0.98-6.39). Child-Pugh classification and low platelet count were common risk factors regardless of whether HCC was present or not.

CONCLUSIONS

Portal vein tumor thrombus, but not the presence of HCC, was a significant risk factor for aggravation of EV in patients with HCC. Cirrhotic patients with portal vein tumor thrombus should receive more aggressive management of portal hypertension to prevent aggravation of EV.

Authors+Show Affiliations

Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17295878

Citation

Kadouchi, Kaori, et al. "What Are the Risk Factors for Aggravation of Esophageal Varices in Patients With Hepatocellular Carcinoma?" Journal of Gastroenterology and Hepatology, vol. 22, no. 2, 2007, pp. 240-6.
Kadouchi K, Higuchi K, Shiba M, et al. What are the risk factors for aggravation of esophageal varices in patients with hepatocellular carcinoma? J Gastroenterol Hepatol. 2007;22(2):240-6.
Kadouchi, K., Higuchi, K., Shiba, M., Okazaki, H., Yamamori, K., Sasaki, E., Tominaga, K., Watanabe, T., Fujiwara, Y., Oshitani, N., & Arakawa, T. (2007). What are the risk factors for aggravation of esophageal varices in patients with hepatocellular carcinoma? Journal of Gastroenterology and Hepatology, 22(2), 240-6.
Kadouchi K, et al. What Are the Risk Factors for Aggravation of Esophageal Varices in Patients With Hepatocellular Carcinoma. J Gastroenterol Hepatol. 2007;22(2):240-6. PubMed PMID: 17295878.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What are the risk factors for aggravation of esophageal varices in patients with hepatocellular carcinoma? AU - Kadouchi,Kaori, AU - Higuchi,Kazuhide, AU - Shiba,Masatsugu, AU - Okazaki,Hirotoshi, AU - Yamamori,Kazuki, AU - Sasaki,Eiji, AU - Tominaga,Kazunari, AU - Watanabe,Toshio, AU - Fujiwara,Yasuhiro, AU - Oshitani,Nobuhide, AU - Arakawa,Tetsuo, PY - 2007/2/14/pubmed PY - 2007/6/5/medline PY - 2007/2/14/entrez SP - 240 EP - 6 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 22 IS - 2 N2 - BACKGROUND AND AIM: The risk factors for aggravation of esophageal varices (EV) in patients with hepatocellular carcinoma (HCC) are poorly understood. The aim of this study was to evaluate the effects of HCC on the appearance of the red color (RC) sign on EV and also investigate whether risk factors for the appearance of the RC sign differed between patients with and without HCC. METHODS: A total of 243 patients with cirrhosis (127 with HCC, 116 without HCC) without the RC sign, with no previous variceal hemorrhage, and not on prophylactic treatment for EV were enrolled. The endpoint was defined as being either when the RC sign was first noted, or when variceal bleeding occurred. In patients without HCC, follow-up was discontinued if HCC was discovered. The risk factors were analyzed by Cox proportional hazards regression. RESULTS: In patients with HCC, portal vein tumor thrombus was a statistically independent risk factor (risk ratio [RR] 4.58, 95% confidence interval [CI] 1.32-15.86), although the presence of HCC was not. A large HCC (> or =50 mm) tended to be a risk factor, but this was not statistically significant (RR 2.50, 95%CI 0.98-6.39). Child-Pugh classification and low platelet count were common risk factors regardless of whether HCC was present or not. CONCLUSIONS: Portal vein tumor thrombus, but not the presence of HCC, was a significant risk factor for aggravation of EV in patients with HCC. Cirrhotic patients with portal vein tumor thrombus should receive more aggressive management of portal hypertension to prevent aggravation of EV. SN - 0815-9319 UR - https://www.unboundmedicine.com/medline/citation/17295878/What_are_the_risk_factors_for_aggravation_of_esophageal_varices_in_patients_with_hepatocellular_carcinoma L2 - https://doi.org/10.1111/j.1440-1746.2006.04418.x DB - PRIME DP - Unbound Medicine ER -